UnitedHealthcare's motion to dismiss class-action suit on cancer therapy coverage denied

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A class-action lawsuit accusing UnitedHealthcare of improperly denying a cancer treatment known as proton beam therapy moved forward this week after a federal judge refused to toss the case, according to court documents obtained by Becker's Hospital Review.

U.S. District Judge Allison Burroughs denied UnitedHealthcare's motion to dismiss the case March 8. 

In the lawsuit, Kate Weissman, Richard Cole, and Zachary Rizzuto claim UnitedHealthcare deceptively and unfairly administered their health plans by refusing to cover proton beam therapy because it is more expensive than traditional cancer treatments. More specifically, the complaint alleges UnitedHealthcare breached its fiduciary duty as a health plan by denying their requests for pre-authorization for the treatment and improperly categorized the FDA-approved treatment as experimental.

In its motion to dismiss, UnitedHealthcare argued that proton beam therapy had not been proven to be more effective than traditional radiation therapy. 

UnitedHealthcare said it intends to "vigorously defend this matter" in court. 

"We are committed to providing our members coverage for safe, proven and clinically effective health care services, which is why we rely on guidance from medical societies, published studies and evidence-based protocols to make these coverage decisions. We cover cancer therapies including, for some cancers, proton beam therapy. We continually review and update our medical policies and coverage decisions based on the most current published clinical and scientific evidence."

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